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Carpal Tunnel in League Esports, explained in 5 minutes

By Sharon Coone
May 16, 2017

You’ve probably heard of Carpal Tunnel -- the quiet killer of esports careers, a syndrome that gives players intense hand pain or even forces them into retirement. But just what is Carpal Tunnel Syndrome, and how much of a danger is it really to our favorite League of Legends players?

What is carpal tunnel syndrome?

The Carpal Tunnel is actually a part of your body, a small tunnel in your wrist made of bone and ligament. Running through it are nine tendons that flex your fingers, as well as the Median Nerve, which carries signals to and from the brain so that you can control your thumb and feel things in this half of your hand.

Because the space in this tunnel is so limited, harsh movements and tissue swelling can put pressure on the nerve, and make it harder for it to transfer information to and from the brain. That’s when you get early carpal tunnel symptoms -- tingling, numbness, burning, and other weird sensations in fingers that the median nerve is responsible for. Eventually it can cause hand weakness and trouble with fine motor skills. In the most extreme cases, people can lose portions of their thumb muscles to deterioration, or the ability to feel hot and cold in parts of their hand."

Why do players get it?

A lot of different things can lead to carpal tunnel syndrome, like genetics or medical conditions. But when it comes to gaming, the problem is mainly how often we play, and how easy it is to binge. Pro players spend dozens of hours a week on their PCs, either scrimming with their team, practicing in solo queue, or just enjoying some casual play in their off time. All of this play time has way more actions per minute, or APMs, than casual computer use. That intense and frequent finger movement can cause swelling and thickening of the tendons in the carpal tunnel, putting pressure on the median nerve. But while those are the physical causes of Carpal Tunnel, psychology plays a big part. Because most players are fairly young, they’re more likely to dismiss minor body pains.

“We're more apt more likely to just brush it off and pretend that it's not a big deal but it's because of that same devaluing of the sensations that we feel it's what leads to us getting to this point where the carpal tunnel syndrome or the pressure on the nerves gets bad enough where we do have to stop playing or where it actually limits us from being able to do what we love, which is playing games”

That was Matt Hwu, CLG’s Head of Physical Performance and Esports Medicine.

Carpal Tunnel's history in League Esports

League of Legends has seen its own share of carpal tunnel troubles. Toyz, midlaner for Season 2 champions Taipei Assassins, suffered with his Carpal Tunnel diagnosis until his retirement in 2013. He did eventually return to pro play, but his story is one Matt thinks shouldn’t happen in esports anymore.

“It is never something that any pro or casual player needs to retire from. And the main reason is because it's rehab is extremely straightforward in how we manage it."

It just takes the right changes in lifestyle, posture, and ergonomics to relieve pressure on the nerve and give it time to heal. In fact, not only is early Carpal Tunnel highly manageable, it’s also not as common as players fear.

“So I want to go over the biggest myth that every gamer needs to know when it comes to carpal tunnel syndrome or just wrist pain in general. So all of us no matter how what we're feeling on our wrists, we think immediately that we have carpal tunnel syndrome. Most of the time it's just that we have a little bit of aching or a little bit of discomfort and that's more relative to something like a muscle irritation or tendon irritation or even a minor strain. Nothing severe enough to the point where we have to say hey we have stage 10 carpal tunnel syndrome. It’s not that.”

How players prevent carpal tunnel

Today, carpal tunnel isn’t the brushed-off career ender it once was. Players don’t whisper the name across gaming house halls like it was Voldemort. Instead, esports organizations are tackling it head on, bringing in physical therapists like Matt to educate players on the risks of long hours, monitor their wellbeing, and manage any injuries.

Esports players are also getting some new accessories out of it -- braces and therapeutic tapes that restrict their wrist movement during play, and guide muscle use to reduce strain on tendons. There are the technical accessories too, like specialized mouses, keyboards, and support pieces that keep their bodies in more comfortable positions.

On the extreme end of things, players can get cortico-steroid injections or take medication to temporarily get rid of inflammation and pain. Or they can undergo “carpal tunnel release procedure” and have their tunnels sliced open, and spend weeks or even months in recovery.

“If there's just one thing I can leave to our community in terms of one piece of advice, it would just be to listen to your body.” If you feel uncomfortable while playing, take a break, change your posture, and make sure you’re not ignoring any strange feelings. With safe techniques and the help of health professionals like Matt, we can keep wrist tunnels everywhere safe.

Sharon Coone profile
Sharon Coone
Sharon spent three years as a video game encyclopedia (Editor in Chief) at Twinfinite. Now she just brags about the time she got to Gold in League of Legends using a trackpad.
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